Can’t afford a medical aid in South Africa? Here are some options to consider

South Africa has some of the most expensive medical aids in the world. Only 16% of South Africans can afford private healthcare at all – and with inflation and unemployment on the rise, that number is likely to shrink even further.  

According to the World Health Organization:

“South Africa spends more on voluntary private health insurance (42%) as a share of total health expenditure than any other country in the world. It serves, however, only 16% of the population.” 

Sadly, this means there are lots of people left without any medical cover at all. If illness strikes or an accident happens, their only option is to receive care from State hospitals – which do their very best but have extremely limited resources and huge numbers of patients to try and assist. 

Thankfully, there are also a growing number of ways you can access quality healthcare and cover yourself and your loved ones against medical emergencies and dread illnesses without breaking the bank. In this post, we take a quick look at why medical aids in SA are so expensive, and what the alternatives are.  

Why are medical aids in South Africa so expensive? 

In a nutshell, it all comes down to something called Prescribed Minimum Benefits, or PMBs. To be allowed to call themselves a ‘medical scheme’, medical aids need to cover all of these. (Members of a ‘medical scheme’ can claim some of their premiums back in tax, while those with a ‘hospital plan’ or ‘health insurance cannot.)

What are PMBs?

According to the Medical Schemes Act, medical schemes must cover the costs related to the diagnosis, care, and treatment of:

• Any emergency medical condition
• A limited set of 271 medical conditions
• 26 chronic conditions

Many of these PMBs can only be treated by specialists, whose services are not regulated, and as a result may charge as much as 700% of the medical scheme rate. 

What this means is that medical aids, on average, spend about R866 per member in order to cover PMBs. In other words, if they don’t charge at least R866 per month, they can’t make any profit at all. 

What other options do I have? 

If you’re one of the many South Africans looking for affordable medical aid, a number of services are offered to bridge the gap. Namely: 

Hospital plans: 

As the name suggests, these cover unforeseen emergencies, accidents, or illnesses which require hospitalisation. At the most basic level, these offer cheap healthcare, and allow you to access private hospitals affordably if the worst happens. 

Health insurance: 

Either as standalone or as an add-on product to a hospital plan, these give you some additional healthcare benefits. For a higher premium, you can access services like GPs, opticians, and dentists as part of your cover. 

Here at EMERGIVAC, we take things one step further by partnering with the Clientele as an underwriter. In medical emergencies, we’ll be by your side to make sure you get access to the best possible healthcare. 

This includes arranging for you to be attended by paramedics, and transported to the nearest private hospital. Your cover includes:

• R150 000 individual cover, or R375 000 family insurance cover limit per annum
• Life insurance – Accidental death cover of R20 000 per individual
• Accidental disability insurance of R20 000 per individual 

Our pricing starts from just R249 for an individual, including medical and trauma assist, armed response cover, roadside, and household assist services. EMERGIVAC is not a medical aid, but thanks to our partnership with Clientele, we can give you peace of mind that you and your loved ones are covered in a crisis. 

See our pricing or benefits page for more details, or reach out to one of our friendly advisors for more information.